House Republicans are soon expected to pass their bill repealing
the national health care law, but the bill won’t go any further
than that given Democratic control of the Senate.
To do a clean repeal of the entire bill, Republicans would have
to maintain control of the House in 2012 while gaining the White
House and a 60-vote majority in the Senate. That’s unlikely to
happen, which means that it’s more likely Republicans will have to
pursue a more piecemeal approach. In the short term, there will be
some efforts to defund ObamaCare — but that will only get them so
far. If Republicans are willing to use reconciliation, however,
they could make a major dent in ObamaCare with a simple majority in
the Senate. Though this method would still require them to take
back the White House, they wouldn’t need 60 votes in the
Senate.
Last year, I
spoke with former Senate parlimentarian Robert Dove about the
prospect of repealing ObamaCare through reconciliation, and he gave
me this simple formula: “Anything that reduces the deficit is
okay…and nothing that increases the deficit is okay.” The key
thing to keep in mind is that this is judged on a provision by
provision basis, not taking into account the legislation as a
whole.
What this means is that it will require a lot of political
fortitude by Republicans, because to meet the requirements of
reconciliation, the bill would have to focus on rescinding
benefits, which account for the bulk of the cost of ObamaCare.
Chief among them are the expansion of Medicaid and the subsidies to
purchase insurance on government run exchanges. The Republicans
would not be able to use reconciliation to repeal regulations, tax
increases, or Medicare cuts.
However, were they to show the courage to repeal the government
benefits, it would make it easier to go after other aspects of the
bill. Without the subsidies to purchase insurance, the new
exchanges that provide the infastructure for ObamaCare would be
effectively gutted and the mandate forcing people to purchase
insurance becomes even harder to defend. At the same time, it would
be difficult to justify the tax increases — totaling $770 billion
through 2021.
Today’s vote on repeal, as I noted before, is a
no-brainer — it’s the bare minimum Republicans should do. But
it is only the first step in a long and arduous process that will
require an increasing amount of resolve by Republicans.